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15940 SW ROYALTY PARKWAY 15940 SW Royalty Pkwy CITY OF TIG ARD 24-Hour BUILDING Inspection Line: (503) 639-4175 MST INSPECTIGN DIVISION Business Line: (503)639-4171 BUP Received _ _ Date Requ sted._.__ W��_AM_—_- PM __ BUP Location S / 76 + �1��/� Suite. --_ MEC h l Contact Person __ LSC.. ' — !� _.._) _ PLM Contractor - - _ pt,(-._-) SWR BUILDING Tenant/Ownar __ ELC Footing --- ELC - Foundation Access: Ftg Drain ELR - Crawl Drain - SIT -- Slab Inspection Notes: -- - Post&Beam - --- -- ---- --- __ Shear Anchors — Ext Sheath/Shear Int Sheath/Shear Framing - ----- ... -- Insulation i; Drywall Nailing Firewall Fire Sprinkler - ----- — Fire Alarm Sus 'd Ceiling Other: -._-_.. -- - - - ----- ---------- --------_... ------ --- PART FAIL LUMBINC ----- Post&Beam Under Slab --.---- -- Rough-In _ Water Service Sanitary Sewer ----- ---- - -- Rain Drains Catch Basin/Manhole StormDrain _____----------__-- --_ _ ------- --------_._---------- Shower Pan ---------- - Final PASS PART FAIL MEC_H_ANICAL ®._ -- - ----- - _-- -- ....--- -- ----- -- ------ -- - Post&Beam Rough-In Gas Line Smoke Dampers --- -----------------.._._----- ------. ----- ._..- - Final PASS PART FAIL -PASS -- R ELECTRICAL Service � ----- ------- --- —__-- Rough-In __ _- _ --- ---- ---- ----- ..T---- ---- UG/Slab Low Voltage - Fire Alarm - Final CJ Reinspection lee of$ required before next inspection. Pay at City Hell, 13125 SW Hall Blvd. PASS PART FAIL_ SITE Please call for reinspection RE Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Dats tC'�_ Inspector A _ - _ Ext ---- Other: Final pO NOT REMOVE this Inspection retort` '4om the Job site. PASS PART FAIL CITYOF TIG,ARD ---- BUILDING PERMIT ZW2601\�, PERMIT #: BUP2002-00378 DEVELOPMENT SERVICES DATE ISSUED: 9/3/02 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639-4'171 PARCEL: 2S110CC-00500 SITE ADDRESS: 15940 SW ROYALTY PKWY SUBDIVISION: KING CITY NO. 3 ZONING: BLOCK: LOT: 014 JURISDICTION: KIN REISSUE: FLOOR AREAS _EXTERIOR WALL CONSTRUCTION CLASS OF WORK: At f- FIRST: sf N: S: E: W: TYPE OF USE: SF SECOND: sf _ — PROJECT OPENINGS_? TYPE OF CONST: sf N: S. E: W: OCCUPANCY GRP: R3 TOTAL AREA: 000 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED: STOR: HT: ft GARAGE: sf OCCU SEP. RATED: BSMT?: MEZZ?: _READ SETBACKS_ REQUIRED_ FLOOR LOAD: psf LEFT. it RGHT: ft PFIR SPKL: T SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 6,135.00 Remarks: Re-roof Owner: Contractor: ROSS EBERTS INTERSTATE ROOFING 15940 SW ROYALTY PKWY 15065 SW 74TH AVE. KING CITY, OR 97224 TIGARD, OR 97223 Phone: 503-603-9403 Phone: 684-5611 Reg#: LIC 55485 FEES _ a^ _ REQUIRED INSPECTIONS Type By Date Amount Receipt Roof Nailing Insp PRMT CTR 9/3/02 $110.50 27200200000 Dryrot After Tear-Off Insp Final Inspection 5PCT CTR 9/3/02 $8.84 27200200000 Total $119.34 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-1987. You inay obtain a copy of these rules or direct questions to OUNC by calling (503)246-6699 or 1-800-W-12 44. Permittee ' Signature: Issued By: - __ ------- —__ Call 639.4175 by 7 p.m. for an inspection the next business day 1 TRI-rOUNTY SERVCECEN ER Building Permit Application 1 �( ��1 City of King City Date received: 3 D Z Permit �,\,' •` j 13125 SW Hall Blvd, ��' Pro)ect/appl.no.: Expire date: �� Tigard.OR 97223 Date issued: By. (� Receipt no.. Clackamas Multnomah Phone: (503)639-4171.FAX: (503)684-7297 Case:file no- Payment tvfie: WasL, N T I E S Land use approval: 1&2 family Simple Complex: _— Will k 1 I & '_family dwelling or accessory ]Commercial/industrial J Vtulti-family ❑New construction 0 Demolition Addition/alteration/replacement J Tenant improvement J Fire sprinkler/alarm J Other. JOB SIITE INFORMATION Job address: c C Su.' /�G «( /rrtG' _ _ Bldg.no.: Suite no.: Lot: Block: Subdivision: Tax map/tax lot/account no.: h Project name: Dewnpuon and location of work on premises/special conditions. 01ito le- d_ L-Z lY1cy��(�' _l'laaet tttr'�t (j) 16fC lcf� +,e_s !c'Shxcf _!tib//1_�C/J T it�wt'� �fe/ 3G'�1ra� r as�lr OWNFR 1 ' SPECIAL INFORINIATION, Name: Gt.Ss Eb��♦>`s Mailing address: /Sl%t/C- S« if.c"G cte otct' I & 2 f:unily dwelling: City: 0</r r� State:�'k 'Z.IP: �',» y Valuation of work......................................... S .._ rE-mail: No.of bedrooms/baths.................................. �� Z Owner's representative: Total number of floors.................................. i Phone: Fax: E-mail: New dwelling area(sq.ft.)............................ Garage/carFort area(sq. ft.).......................... Covered porch area(sq.ft.) Name: �ilfie'rs'7�7fG ��G'C.r-��t�j -�3�/r`- /6,r/Ga/c/ .......................... Mailing address: lSrr�5- S.t`Tyyt�r Deck area(sq. ft.).......................................... City: L 91(et t•re: State:C Lj ZIP: 11,7224" Other structure area(sq. ft.).......................... Phone i v5y Fax: s I — c -_Z71.F-mail: Cm omercia[Andustrial/multi•family: 5r i �3. 1c 1 NTRAUFOR Valuation of work......................................... S Existing bldg.area(sq.ft.)............................ -- Business name: �1�4 ty f�, f c ke. — -/ New bldg.area(sq.ft.) ................................. Address: /5 4•L'' S S LC 'y -r--- Number of stories.......................................... _ City: ISwte: — Phone: sc_i e s y 54// Fax:,::93<1?d5 E-mail: Type of construction.................................... CCH no.: SS g'� Occupancy group(s): Existing: -- �— New: City/metro lic no r2'��. Notice: All contractors and subcontractors are requited to be t licensed with the Oregon Construction Contractors Board under Name: provisions of ORS 701 and may be required to be licensed in the Address: jurisdiction where weak is being performai. If the applicant is City: State: ZIP: exempt from licensing,the following reason applies: Contact person: Plan no.: — Phone: F;l I Name: oni.t i iwrson: Fees due upon application.............................S Address: Date received: _City: State: -77_IP: Amount received...........................................S _---- Phone: Fax' rnai!: Plense refer to jet schedule. I hereby certify I have read and examined this application and the Not all putvh,.tmns xcept credit cards,pleas call iunsdn-tutn for more mformaeuro attached checklist. All provisions of laws and ordinances governing this -I vial J%taaettard work will be compiled with.wheth -%pechied hereil.ter not Credit card numher Aurhori:ed signature � �, / Date: �� 7—�_? Name of cardholder ae shown on credit card Print name: _ s__ `— Cardholdersl/amure S Amount ,Vooce:This permit opplieation expires if a permit is not obtainod within 180 days after it has been accepted as complete. JW)f6l I IMNK-m 0 KING CITY 15300 S:N. 116th.avenue,lung C:,y,Oregon 97 4.2693 Phone:(503)639.1082•FAX(503)639-3-4 71 Notice To Contractors `Vorking In King City Due to an intergovernmental agreement with the City of Tigard, many building related permits for projects in King City are issued and inspected b-,the City of Tigard. If your permit application DOES NOT REQUIRE PLAN REVIEW, simply complete the appropriate application legibly and submit it to the King City staff. The King City staff will collect all fees and fax the application to the Cit,-of Tigard. City of Tigard staff«ill then create the permit. issue the permit. and perform inspections. Please indicate on the permit application whether you would like the Tigard staff to call you when the permit is ready for issuance or whether you prefer it to be mailed witho any notification. Any incomplete or illegible application will be returned to King City staff for correction and no processing will occur until a complete. legible application is received. If your permit application DOES REQUIRE PLAN REVIEW, this form must be signed by a King City staff person. King City staff«ill simply sign this form indicating land use approval. Take this !lgned form to the City of Tigard Development Services Counter located at 13125 SW Hall Blvd. Tigard, to submit applications and plans. Development Services Technicians are available at 639-4171 Ext. 304 should you have any questions concerning submittal requirements. All permit fees will be assessed and collected at the City of Tigard. The City of King City hereby authorizes applicant to pursue permits at the City of Tigard Building Department for the following project: located at: /s y " l_ ) 64_lLbb King City Represent iye I osis XCI\ST noc CITYOF TIGAR D ELECTRICAL PERMIT PERMIT#: ELC2002-00345 DEVELOPMENT SERVICES DATE ISSUED: 7/24/02 13125 SW Hall Blvd.. Tiqard, OR 97223 (503) 639-4171 PARCEL: 2S110CC-00500 SITE ADDRESS: 15940 SW ROYALTY PKWY SUBDIVISION: KING CITY NO. 3 ZONING: BLOCK: LOT : 014 JURISDICTION: KIN Project Description: Installation of(2)branch circuits. _ RESIDENTIAL UNIT_ TEMP SRVC/FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: PUMPIIRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: MANE HMI SVC/ FDR: 601+amps - 1000 volts: MINOR LABEL (10): SERVICE/FEEDER _ BRANCH CIRCUITS _ ADD'L INSPECTIONS 0 200 amp: W/SERVICE OR FEEDER- PER INSPECTION: T 201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR: 401 - 600 amp: FA ADD'L BRNCH CIRC: 1 IN PLANT- 601 - 1000 amp: _ PLAN REVIEW SECTION _ 1000+ amp/volt: >=4 RES UNITS: ^> 600 VOLT NOMINAL: -_.__._ Reconnect only: — �SVCIFDR >=225 AMPS_ CLASS AREA/SPEC OCC: Owner: Contractor: NEUBAUER, HELEN M ALL-WAYS ELECTRICAL 15940 SW ROYALTY PKWY 6032 SE BREWSTER PL KING CITY, OR 97224 PO BOX 68456 MILWAUKIE,OR 97267 Phone: Phone: 513-6614 Reg#: SUP 1287S LIC 49032 ELE 3-229c FEES T Required Inspections Type By Date Amount Receipt Rough-in 5PCT CTR 7/24/02 $4.28 2720020000( Elect'I Final PRMT CTR 7124/02 $53.50 2720020000( Total $57.78 This Permit is issued subject to the regulations contained In the Tigard Municipal Code,State of OR.Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This pei mit will expire if work is not started within 180 days of Issuance,or N work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth In OAR 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC at(503)246-6699 or 1-800-332-2344, 1 Permit Signature: issued By: OWNER 4STALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: _ _ _ DATE:_ _ -------------_,CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N > Evt, Tom,�✓r��- __ DATE: _ LICENSE NO: mall 639-4175 by 7:00pm for an inspection the next business day Electrical Permit Application Date received: 14/I: - Permit no.: City of Tigard Project/appl.no.: Expire date: Ciry„jTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receiptno,: Phone: (503) 639-4171 Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: - e I rfamily dwelling or accessory U Commercial/industrial U Multi-family UTenant improvement U Newconsuction U Addition/alteration/replacement U Other: U Partial Joh address: C. 0' ' BI g. no,: Suite no.: Tax map/tax lot/account no.: Lot: Block: Subdivi.ion: - Proiect name: _ Descri ptiorvfind locatiod of work on premises: _ Estimated date of completion/inspection: 1 t I,c \ray Job nor Description Qh (ea.) total nu.imp Business na e: NewresWencial-singleonnulti-famih tw, Address: dwellingunit.hlcludesanaclwdgarage. City: j State: ! ZIP: C - Service Included: o(1O sq ft.or less 4 Phone: -'ax:S/3 f,41 E-mail: Each additional SW s .ft,or portion thereof a CCB no,: C s't Elec,bus.lic.no: 3- 2c Q' Limited energy,residential 2 QtYhrN,lro lic.no.: Lin,ttedenergy,non-residential 2 —(1), tach manufactured home or modular dwelling Service and/or feeder 2 n c of u ?ng lcc ician(re aired Date _ Services or feeders-Installation, Sup.elect.name(print): -4VOW 1 / - - ' License no: alteration or relocation: 200 maps or less 2 201 amps to 400 amps 2 Name(print): 401 amps to 600 amps 2 Mailing address: 601 ams to 1000 amps _ 2 City: --ISlatC: ZIP __ Over 1000 amps or votes 2 fax: 1-mail: Reconnect only Phone: 1 7'emporory services or traders- Owner installation:The installation is being made on property 1 own installation,alteration,or relocation: which is not intended for sale,leis w,rent,or exchange according to 2W amps or less ORS 447,455,479,670,701. 201 amps to 4(x)amps _ ' Owner's signature: Date: _ 401 to 600 ams 2 l Bram:h circuits-new,alteration, ore%tension per panel: :Address: me: _- A Pee fur branch circuits with purchase of service or feeder fee,rack branch circuit2 Stale LIP: B. Fcc for branch circuits without purchavc y: of service or feeder fee,first branch circuit: 2ttle: s Fax: E-mall: Each uddttior.al hr- : Misc.(Service or feeder not Included): Each pump or irrigation circle 2 •Service over 225 nmps-conunercial U Health-cure facility Each sign or outline lighting _ 2 •service over 320 amps-rating of I del U Hazardous location Signal circuit(s)or a limited energy panel, family dwellings U Building over 10,w)syunre feet lour or g U System over 6(x)volts nominal more residential units in one structure alteration,or extension• U Building over three stories U Feer.lers,AIM amps ormore •lkscri tion: -- U tkcupmtt load over 99 persons U Manufactured structures or H park Fach additional Inspection over the allowable in any of the above: U I:gress/lightingplan U Other: _.., Perinspectian —� Submit sets of plans with any of the above, lnvestigati.n fee _ lite above are not applicable to temporary construction service. ()'herNot _ Permit fee............. ...$ ad„ c Not all jurischctious xcept credit canto.phase call jurisdiction fm mrnr intormntiar. expire:il'a permipennt snot obtain Plnn review(at _ %) $ _ ❑Viso U MasterCard expires if a permit is not obtained within 180 days after it has — "— Credli card nuruher: — xplrcs accepted as complete. been TOTAL .....ge,(896) .,,,S Name of cardholder u Shawn nn r II card _�.. Cardhuldrr lipature $ _— Amnurn— E X P U D 440.4611(WWOM) ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FLES: TYPE OF WORK INVOLVED -RESIDENTIAL ONLY Complete F'ee Schedule Below: Restricted Energy Fee...................................................... $75.00 Number of Inspections per permit allr,vpd (FOR ALL SYSTEMS) Service included: Iterns Cost Total Check Type of Work Involved: Residential-per unit 1000 sq ft,or less $145.15 _ 4 ❑ Audio and Stereo Systems' Each additional 500 sq,ft.or portion thereof _ $33.40_ 1 ❑ Burglar Alarm Limited Energy _ $75.00 _ Each Manufd Home or Modular Dwelling Service or Feeder $90.90 2 ❑ Garage Door Opener' Services or Feeders ❑ Heating Ventilation and Air Conditioning System* Installation,alteration,or relocation 200 amps or less $80.30 _ 2 201 amps to 400 amps _ $106 ro 2 ❑ Vacuum Systems 401 amps to 600 amps _ :,r;..30 2 601 amps to 1000 amps $240.60 _ 2 ❑ Other Over 1000 amps or volts $45465 Reconnect only $66.85 Tempomry Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY Installation,alteration,or relocation Fee for each system.......................................................... $71,rill 200 at ips or less $66.85 2 (SEE OAR 918-260-260) 20 at rna rn 400 amps $100.30 2 401 daps to b00 amps $133.75 2 Check Type of Work Involved: ON or 600 amps to 1000 volts, see"o"above. ❑ Audio and Stereo Systems Braych Circuits ❑ New,alteration or extension per panel Boiler Controls a)The fee for branch circuits wf(h purchase of service or ❑ Clock Systems feeder foe. Each branch circuit _ $6.65 _ C� Data Telecommunication Installation b)The fee for branch circuits without purchase of service 5 or feeder lee. Fire Alarm Installation First branch circuit $46.85 Each additional branch circuit $6.65�— HVAC Miscellaneous in--trumentation (Service or feeder not Included) - Each pump or irrigation circle $53.40 ❑ Each sign or outline lighting _ $53.40 Intercom and Paging Systems Signal circuit(s)or a limited energy panel,alteration or extension $75.00 ❑ Landscape Irrigation Control' Minor Labels(10) $125.00 Each additional Inspection over E:] Medical the allowable in any of the above ❑ Per Inspection _+�� $62.50 Nurse Calls Per hour _ $62.50 In Plant _ _ $73.75 ❑ Outdoor Landscape Lighting' Fees: ❑ protective Signaling Enter total of above fees $ F] Other_ 8%State surcharge $ g ^—Number of Systems 25%Plan Review Fee See"Plan Review"sectioi.un $ No licenses are required Licenses are required for all other Installations front of application, Fees: Total Balance Due $ Enter total of above fees ❑ Trust Account p _ _- 8%State Surcharge $ Total Balance Due $ All New Commercial Buildings require 2 sets of plans. i:\dsts\fnrmsktc-fees.dbc 08!30/11